ESSENTIAL CAREGIVER REQUIREMENTS & RESTRICTIONS
EFFECTIVE at 12:01 am on July 1st, 2022, any Essential Caregiver of an in-patient or attendance with a patient for an out-patient procedure will be required to perform self-screening for the following:
- New/worse cough
- New/worse shortness of breath
- Decrease/loss of smell or taste
- Sore throat
- Runny nose/nasal congestion
- Tested positive for COVID-19 in the previous 10 days
- Exposure to a COVID-19 positive case in the previous 10 days (without a mask)
- Have been told to quarantine by a physician, PHAC, CBSA or the Public Health unit
Visitors should be prepared to provide proof of:
- Their COVID-19 vaccination evidencing 14 days has passed since their second dose of a COVID-19 vaccine.
- A negative community-based PCR (polymerase chain reaction test) or antigen test result taken within 3 days before their visit.
No visitation is allowed for patients with active confirmed or suspected COVID receiving an aerosol-generating procedure- Resolved cases may have Essential Caregivers as identified below. Limited exemptions are available for parents/guardians of a child with confirmed or suspected COVID-19.
EFFECTIVE July 1st, 2022 WRH will allow TWO essential caregivers at the bedside at a time within the allotted visitation.
For palliative patients, 2 essential caregivers at a time, may visit 24/7 4 essential caregivers at a time, 24/7 for a patient that is actively dying/end of life, or having a planned withdrawal of life support. This may include visitors less than 18 years of age when accompanied by an adult.
Some limitations may apply to the number of visitors allowed at one time based on the clinical space restrictions.
All visitors must wear a medical-grade mask at ALL times and in ALL areas of the hospital. If visitors do not have one they will be provided with a medical-grade mask at the entrance. Cloth masks by themselves will not be allowed.
All visitors may be required to eye protection while visiting a patient. Face shields will be provided to visitors on the unit if required. Please refer to our policy regarding these issues.
No visitation is allowed for patients with active confirmed or suspected COVID-19, that are receiving aerosol-generating medical procedures including but not exclusive to non-invasive ventilation (BiPAP, CPAP) or high flow oxygen (AIRVO, Optiflow) due to the extremely high risk to patients, staff, and visitors. Please refer to the nursing unit for clarification. Virtual visits for these patients will be supported using technology such as iPads. Resolved cases may have visitors as identified in this policy.
ESSENTIAL CAREGIVERS WILL BE RESTRICTED IF THEY:
- Are under the age of 18, unless they are the parent/guardian of the patient or are accompanied by an adult visiting a palliative/end-of-life patient.
- Are symptomatic
- Have been outside of Canada in the last 14 days and have been advised to quarantine upon their arrival.
- Have tested positive for COVID-19 (and are not resolved cases)
- Have had close contact with a confirmed case or probable case of COVID-19
- Have had close contact with a person with an acute respiratory illness who has been outside of Canada in the 14 days before their symptom onset
- 10 am to 8 pm (except Critical Care units)
- 10 am to 6 pm, and 8 pm to 10 pm (Critical Care units only)
- For Mental Health and Renal Dialysis please see below
- Cancer Program - For scheduled outpatient cancer appointments with a provider, the patient may have two essential caregivers accompany them. For treatment appointments in the systemic therapy suite, for radiation therapy or to attend the Cancer Program Lab or Diagnostic Imaging, the patient may have one essential caregiver accompany them.
- Emergency Department - 24 hours, one Essential Caregiver per patient- may not enter until the patient has been brought in from the waiting room unless the patient requires support due to cognitive, mobility or other disability or is pediatric- in this event, one Essential Caregiver may accompany in the ED waiting room. Department will contact when Essential Caregivers can enter.
- Lab and Diagnostic Imaging - Patients with cognitive, mobility, or other disability, is pediatric or their appointment is after 1700 will be allowed one Essential Caregiver who will remain with the patient for the entire visit or in a space designated by the clinical team if a procedure requires it. Obstetrical and Cancer Program patients may have one essential caregiver attend for support.
- Labour and Delivery/Postpartum care - Two essential caregivers may be at the bedside at a time, including the use of any private support services such as a doula (however, only 1 person is permitted during a C-Section delivery). Only one person (the primary support person) may stay at the bedside overnight in postpartum care (8:00 pm - 8:00 am).
- Obstetrical Triage - One Essential Caregiver with a mom presenting to OB Triage.
- Maternal Newborn Clinic/Women's Health Clinic - One Essential Caregiver with a mom going to scheduled appointments at the Maternal Newborn Clinic or Women's Health Clinic.
- Paediatrics and NICU - For an ill newborn, child, or youth 2 identified Essential Caregivers for inpatients can come and go between 8 am - 8 pm and one of the identified caregivers can stay overnight between 8 pm and 8 am. For outpatients and day surgeries, two identified caregivers can accompany the patient. For inpatient pediatric patients that are COVID-19 positive, 2 identified caregivers may stay with the patient, however, it should be limited to 1 at a time, they must remain isolated in the patient room, and the selected caregivers must be from the same household.
- Mental Health Department - Two Essential Caregivers may be chosen with 1 Essential Caregiver per patient for 30 minutes between 4:00 pm - 8:00 pm. To avoid overcrowding in common areas, we have limited visitation to a maximum of 4 Essential Caregivers being allowed into 3N and 3S and a maximum of 2 Essential Caregivers into PICU at a time. Visits must take place in the designated common area and are not allowed in patient rooms.
- Renal Dialysis Program - In-center dialysis - outpatients (Bell/JM/ESHC): 8:30 am - 10:00 am, 1:30 pm - 3:00 pm, and 7:00 - 8:30 pm (1 fully vaccinated Essential Caregiver per patient). In-patients in JM - to follow hospital visitation hours. Home Programs and MCKC - 1 fully vaccinated Essential Caregiver with patient per clinic visit.
ADDITIONAL INFORMATION FOR THE ABOVE
If the patient in labour is confirmed or suspected of COVID-19:
- Only one Essential Caregiver may be with the patient throughout the patient's stay (no alternating Essential Caregivers)
- The Essential Caregiver remains with the patient in the same physical environment throughout the care delivery
- The clinical team is able to provide Essential Caregiver with a safe environment and teaching necessary for infection control
- The Essential Caregiver is masked and reports to Public Health as they may be required to self-isolate, depending on test results
COVID-19 ASSESSMENT CENTRE
The following people are eligible for molecular testing (PCR or rapid molecular testing):
SYMPTOMATIC people who fall into one of the following groups:
- People aged 70 years and older
- People aged 60 years and older who have less than three doses of the COVID-19 vaccine
- People who are immunocompromised
- Adults aged 18 years and older who have had less than three doses of COVID-19 vaccine and have risk conditions:
- obesity (BMI ≥ 30kg/m2)
- heart disease, hypertension, congestive heart failure
- chronic respiratory disease, including cystic fibrosis
- cerebral palsy
- intellectual disability
- sickle cell disease
- moderate or severe kidney disease (eGFR <60mL/min)
- moderate or severe liver disease (e.g., Child-Pugh Class B or Cirrhosis)
- Other people at higher risk of a severe disease who may be eligible for COVID-19 treatment if they tested positive
- Pregnant people
- Patient-facing healthcare workers
- Staff, volunteers, residents/inpatients, essential care providers, and visitors in the highest risk settings
- Highest risk settings include hospitals (including complex continuing care facilities and paramedic services), and congregate living settings with medically and socially vulnerable individuals, including, but not limited to long-term care homes, retirement homes, First Nation eldercare lodges, group homes, shelters, hospices, correctional institutions, and hospital schools.
- Household members of staff in highest risk settings and patient-facing healthcare workers
- Home and community care workers
- Staff and students in Provincial and Demonstration Schools
- Elementary and secondary students and education staff who have received a PCR self-collection kit through their school
- International Agriculture Workers in congregate living settings
- Patients seeking emergency medical care, at the discretion of the treating clinician
- Other outpatients for whom a diagnostic test is required for clinical management, at the discretion of the treating clinician
- People who are under-housed or experiencing homelessness
- First responders, including fire, police and paramedics
- Individuals who are from a First Nation, Inuit, Métis community, and/or who self-identify as First Nation, Inuit, and Métis, and their household members
- Individuals travelling into First Nation, Inuit, Métis communities for work
- On admission/transfer to or from the hospital or congregate living setting
- People in the context of confirmed or suspected outbreaks in the highest risk settings as directed by the local public health unit
- Individuals, and one accompanying caregiver, with written prior approval for out-of-country medical services from the General Manager, OHIP
- Any patient with a scheduled surgical procedure requiring a general anaesthetic 24-48 hours prior to the procedure date
- Newborns born to people with confirmed COVID-19 at the time of birth within 24 hours of delivery, with a repeat test at 48 hours after birth if the baseline test is negative, or if the parental test results are pending at the time of discharge
- People 24-48 hours prior to treatment for cancer or prior to hemodialysis, at the discretion of the treating clinician